Normal E. coli is harmless and is colonized in our lower intestines. "Food Poisoning" aka bacterial contamination of food with E.coli is *usually*
due to fecal contamination of food via poor washing of raw foods from gardens/markets, fertilizer contamination of foods or contaminated water used in
crop irrigation.

Certain strains produce a Shiga or Shiga type toxin that, in the short version, affects the 28s and 60s Ribosomal subunits, thus halting protein
synthesis within cells. Combo that with an active bacterial overgrowth and infection, you are in trouble. Septicemia/bacteremia will follow. So now
with the intestines bleeding, you start to have bloody diarrhea (losing fluid and blood - very bad). Now the Shiga enters the blood stream and starts
to affect/damage the vascular endothelium (espeically in the Kidney's). Glomerular Filtration in the Kidneys will start to decrease due to the toxin
adhering to the tissue. Welcome to Acute Renal Failure and HUS.

So this E.coli is resistant to aminoglycoside (Amikacin, Gentamicin, Tobramycin), macrolides (Erythromycin) and Beta-lactam antibiotics (Penicillins).
(Personal wager its a ESBL producer which would knock out Cephalosporins as well).
This leaves Carbapenems (Merrem, Invanz, Primaxin) - but with NDM-1 (New Delhi Metallo-1) starting to spread that class may be knocked out. Certain
Fluoroquinolone may be effective still (Ciprofloxacin) but resistance is increasing. Bactrim (Sulfa antibiotic) can still be an option.

So treatment is antibiotics, fluids and many liters of blood a day and Dialysis are the treatments left. Don't forget, the adding of antibiotics
could exacerbate kidney issues and Loperamide (an anti-diarrhea is not to be used).

With the current resistance profile and virulence of the new strain of E. coli, it makes you wonder if it is a laboratory made agent. Don't forget
they are still unsure of the source of the infectious agent (Spain, Germany or elsewhere) or which food is the agent (Killer Cukes, Lettuce or
other).

No doubt it is man-made - the presence of MRSA in milk is also man-made (over use of antibiotics in the dairy process) even if not intentionally.

My guess is it is man-made, may be not intentionally, but just through some kind of fertiliser or chemical issue, perhaps?

We are seeing very worrying symptoms now as we play around with natural processes far too much, always tryng to get the most from the least as in all
aspects of intensive anything! This is just a consequence of not considering the implications and consequences of "fiddling" with nature.

Personally, I would read the signs and learn very very quickly because people die when we get it wrong.

According to China's BGI Shenzen, one of the world's largest gene sequencing labs, the outbreak bug is 93% identical genetically to an E. coli
strain that has caused illness in AIDS patients in the Central African Republic. But the new bug appears to now sport genes that lead to both bloody
diarrhea and kidney failure, as well as resistance to 14 kinds of antibiotics, instead of just one, tetracycline, like before.

What's more, the bugs now lacks an "adhesin" gene (as in "adhesion") usually linked to the germ sticking to things. That may mean it has
replaced that gene with an even nastier way to stick to your gut. Ain't evolution grand?

"This is a very bizarre bug, a fascinating organism," says Lutwick, who teaches at the SUNY-Downstate College of Medicine in Brooklyn and is a
moderator on the widely-followed ProMed outbreak alert network, an emailed update service where doctors post new outbreak developments for each other
. "But these things can happen. In biology they will happen"

I can understand these things happening naturally, but not without selection pressure. What selection pressure is responsible for resistance to '14
kinds of antibiotics'? Why would those same E. Coli be simultaneously pressured to 'stick' to the intestine in a novel way?

All that I can postulate is that somehow there has been a prolonged exposure of the original e-coli cultures to antibiotics that they developed an
immunity to antibiotics in a big way, what else could it be?

I wonder if someone could supply that pressure in a controlled manner in their back yard to produce such an organism? Presumably, if nature can do it
randomly, then man can speed up the process such as in dogs. But does this type of bio engineering necessarily involve expensive machinery or just a
lot of antibiotics and some test subjects?

That is the "Conspiracy" flag on this - A whammy on the antibiotics AND able to produce the Shiga Toxin AND the Adhesion gene....Just like the Swine
Flu or Novel H1N1 (which contained genetic components of human, pig and bird flu), it just smells rotten. Too many coincidences.

New strains of E. coli evolve through the natural biological process of mutation and through horizontal gene transfer. Some strains develop traits
that can be harmful to a host animal. These virulent strains typically cause a bout of diarrhoea that is unpleasant in healthy adults and is often
lethal to children in the developing world. More virulent strains, such as O157:H7 cause serious illness or death in the elderly, the very young or
the immunocompromise.

Virulent strains of E. coli can cause gastroenteritis, urinary tract infections, and neonatal meningitis. In rarer cases, virulent strains are also
responsible for haemolytic-uremic syndrome, peritonitis, mastitis, septicaemia and Gram-negative pneumonia.
E. coli quickly acquires drug resistance,Recent research suggests treatment with antibiotics does not improve the outcome of the disease, and may in
fact significantly increase the chance of developing haemolytic-uremic syndrome.

Bacterial infections are usually treated with antibiotics. However, the antibiotic sensitivities of different strains of E. coli vary widely.

Antibiotic resistance is a growing problem. Some of this is due to overuse of antibiotics in humans, but some of it is probably due to the use of
antibiotics as growth promoters in animal feeds. A study published in the journal Science in August 2007 found the rate of adaptative mutations in E.
coli is "on the order of 10−5 per genome per generation, which is 1,000 times as high as previous estimates," a finding which may have
significance for the study and management of bacterial antibiotic resistance.

Antibiotic-resistant E. coli may also pass on the genes responsible for antibiotic resistance to other species of bacteria, such as Staphylococcus
aureus, through a process called horizontal gene transfer. E. coli bacteria often carry multiple drug-resistance plasmids, and under stress, readily
transfer those plasmids to other species. Indeed, E. coli is a frequent member of biofilms, where many species of bacteria exist in close proximity to
each other. This mixing of species allows E. coli strains that are piliated to accept and transfer plasmids from and to other bacteria. Thus, E. coli
and the other enterobacteria are important reservoirs of transferable antibiotic resistance.

E. coli are highly resistant to an array of antibiotics, and infections by these strains are difficult to treat. In many instances, only two oral
antibiotics and a very limited group of intravenous antibiotics remain effective. In 2009, a gene called New Delhi metallo-beta-lactamase (shortened
NDM-1) that even gives resistance to intravenous antibiotic carbapenem, were discovered in India and Pakistan on E. coli bacteria.

Increased concern about the prevalence of this form of "superbug" in the United Kingdom has led to calls for further monitoring and a UK-wide
strategy to deal with infections and the deaths.

There has been many studies not just about the action of antibiotics interacting with E coli, but also studies have shown there may be a link between
E coli and enviromental pollution. We can say a lot about the interaction of E coli and drugs in a lab. Also small scale tests with chemicals can
produce some interesting information.

but and its a BIG BUT. It is imposible to fully run tests to show what would happen to E coli in respect to the enviroment in real time.
many outbreaks around the world of several diseases has shown that apart from natural mutations, add to this pollution, chemicals used on farmers
fields, drugs for animals, plus add to this mix the changing weather.

Were a disease would only cause mild upset to a human. The introduction of chemical run offs, spraying and drugs that are used by humans entering the
water chain. Can rapidly change a once mild disease into a deadly disease.
Then top this off with an area weather change, some disease are kept down by the area being dry or cold or wet. If for what ever reasons this changes
can have a major impact on the disease.

yes there might be certain groups who would want to develope a disease to change its fatality, this might happen.
But amongst the science field the main worry is that due to human activities in the enviroment and the wide spread use of antibiotice and chemicals.
Will mutate a disease that will have the identities of several disease and multiple vectores to enter the human body.

Without meaning to do it, or due to ignorance we are turning the world into a biological fermentation tank. We introduce one drug or chemical to
combat onething. Without seeing the implications when this element interacts with the enviroment. Many drugs and chemicals are rushed onto the scene,
to combat an outbreak or illness. Then it meets all the other drugs, chemicals, pollution and mutates and returns to haunt us.

Now, not to be tmi here, most antibiotics are renally eliminated, some are hepatically eliminated. Some antibiotics are excreted unchanged...so you
pee or poo and the antibiotic is now in its original form in the water supply/sewer system. I believe that would be under your definition of
environmental contamination.
Hell, we pump up our livestock with so much damn steroids and antibiotics that any meat or fertilizer is just contaminated to high heaven.
To have a "perfect storm" of genetic chances and changes to come together in this situation just screams bogus. Bugs in the wild to produce this
new strain seems nuts.

I was so willing to believe it was Drug Company issue - create superbug and buy our medication or fast track the approval of our new medication I
didn't think about the GMO issue.

So, GMO company X creates a baddie in the lab and drops it in a field. Now that company says if you don't buy our seeds/pesticides/herbicides, you
will let this horrible disease continue? It sounds so far out there UNLESS you know the history of some companies like Mon. Sant. O.

Edit - Also the corrupt backgrounds on Pfi. zer. Or Roche (The makers of Tamiflu)

I was so willing to believe it was Drug Company issue - create superbug and buy our medication or fast track the approval of our new medication I
didn't think about the GMO issue.

So, GMO company X creates a baddie in the lab and drops it in a field. Now that company says if you don't buy our seeds/pesticides/herbicides, you
will let this horrible disease continue? It sounds so far out there UNLESS you know the history of some companies like Mon. Sant. O.

GMO-Food makes you sick,and Drug Companys have the Cure. They work together anyway. Another thing you should know,everything Monsanto is banned here
in Germany...for now. Maybe its a move to force our Politicans to allow GMO back again, because People don´t trust this Virus-infected Organic Food
anymore,and want something which is "save"

"To have a "perfect storm" of genetic chances and changes to come together in this situation just screams bogus. Bugs in the wild to produce this
new strain seems nuts".

When something is introduced to the enviroment it will interact with a multitudes of different agents. Many will have none or minor benign effects on
people, animals and the enviroment. Then it only needs one set of circumstancies to happen. To let it evolve into something dangerous. It might sit
there and not come into contact with humans or it might infect a human with an already infected body and then mutate. Some viruses go through hundreds
and sometimes tousands of mutations in the enviroment with no help from humans. Most of these mutations are benign. Then add to this the amount of
elements we are throwing into the water,air and land.
There are examples through history were human actions on the enviroment have triggered a mutation and it has come back to bite us.

The human or animal body is a ideal bio reactor for viruses. As i said agent A is mutated in the enviroment by meeting agent BCD. In this state it is
a dormant agent, or just a minor irritant to humans. Then it infects a human who is already infected with a virus or infection and then mutates in the
body to form a super bug ect.

This is one of the reasons why drug companies are researching like mad for better and stronger antibiotics. As some have said the antibiotics we have
now will not protect us for many more years. There was a mass of drugs to fight infections now we are down to just a few and these are working less
and less. We are now at the stage that a new drug has to be tailored to fit the new diseases that are showing up.

As it has been said it could be man made it could be a random mutation. We have to be open and not have preconcieved ideas.

Its like going to the doctor and saying i have a major pain in my head and feel sick, and the doctor just saying its a migraine. With the doctor not
running any tests and what has happened is a blood vessel has burst and could lead to death.

Yes industrial contamination with a deliberate or accidental release "could" be possible, but also it could be one of the many natural mutations
that happen every day.

assumptions and ideas are just guesses. The medical and health groups need actual facts and consistant information to respond to an out break.

Seriously? Germany has banned GMO and Monsanto? Wow. Too bad we can't get that here in the States. The guy behind me grows Monsanto (according to
his signage in the field)...all I know is when my dog "sneaks" a bite of the crop, she throws up for 2 days. It could be pesiticides/herbicides and
whatnot but that is a bad sign. I guess it's another reason to move back to the city.

One of the interesting things about this novel E. coli strand is how many people were affected by it. 1800+ (current projection) is usually enough to
start some pretty severe decrease in individual rights. Last E.coli issue I remember was in the end of 2006 and that sickened around 200 people
(another reason not to eat Taco Bell).

10 new antibiotics by 2020. If you do not count the drugs approved in Canada or the EU and not in the US, we are NOT going to make that
goal...yet...

In the last 10 years I can think of Tygacil, Cubicin and only a handful of others, but they don't cover everything (Gram -, Gram +, acid fast,
anaerobic, etc.) We either need a major drug breakthrough or some type of bacteriophage to target/kill bacteria (thanks FDA for now considering them
GRAS - Generally Recognized As Safe).

Yes an interesting read. I have read the same sort of things from other people.

I must say i love the "Potential conflicts of interest" Its like a who's who's.

Yes we need to investigate and produce more drugs to fight infections and diseases. We also have to look at other measures.
A lot of outbreaks happen in countries with either patchy or no medical services. Countries with patchy or no systems set up to observe and report on
outbreaks.
Many of these countries are low on the economic scale and have a large uneducated populance. This is not said in detriment to the people, it just
makes it nearly impossible to be alerted to an outbreak.
Plus some of these countries have long running civil wars that have decimated the whole country.
populations are underfed, lack basic medical care. many times large groups of the population are forced to hike through jungle terrain and over large
areas. many times when these people reach relief camps in other countries. There is an outbreak of many different disease groups.
So by the time agencies observe a unknown virus, it is mostly third or fourth generation. Its virtualy impossible to find patient 0. Who may have
survived, but if dead is proberly in a mass grave or been burnt with other unfortunate victims.
Plus trying to find were the virus was contracted is mostly not possible. these people have travelled for days and interacted with many others. Plus
many areas are too dangerous or cannot be entered due to factions controling them.

Then some countries will try to hush up an infection for many reasons. Mostly economic but also political.
Then some of the big drug companies have been investigated for selling contaminated drugs, out of date drugs and some drugs with such a low level of
ingrediants. the drug is worthless. So if a person is infected with a variant of the virus, the drug is not strong enough to destroy the virus.
Sometimes this helps give the virus an defence against the proper drug when it is discovered.
Then in the west, when an outbreak is confirmed and is reported by the media. Many people want to be given drugs to combat it, even if its not in
their country yet. So some companies sell the so called vaccine or the people buy it over the internet. Most of the drugs sold on the internet are
fake drugs. So even if the people get the real drug many start to take it before they are ill. This many times then makes the drug useless.
Even in well developed countries a new virus will cause many problems, such as is happening now. Plus if a vaccine is needed it can be months before
one is completed. Even then without major trials the vaccine can cause unkown interactions with the virus and may even trigger an effect worse than
the virus.

So yes new drugs are important but so much more work in many areas need to be done as well.

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